…Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant interacting medications The SLCO1B1 rs4149056 polymorphism is associated with higher statin concentrations and may…

…flow and myocardial flow reserve with PET. Evaluate myocardial viability, particularly when combined with metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis, and…

…of infection on the flap is called vegetation. As a rule, some kind of damage to native (own) valves is required to become vulnerable and…

…only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and organ dysfunction must…

…which infection has not been excluded. Indications Acute monoarthritis in which septic arthritis must be distinguished from crystal arthritis — the most important indication and an…

…The commonest cause of wound infection is retained contamination, not poor suture technique — and the commonest cause of permanent loss of function is a tendon…

…are viral infection, bacterial infection and air pollution, but often no definite trigger can be identified [1,2]. Ask specifically about: Onset and time course…

…3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support…

…blood appears in the hub: lower the angle to close to the plane of the skin and advance a further 1–2 mm so that…

…low platelet counts, followed by compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow…

…the most stable dressing, lowest risk of infection and thrombosis with prolonged dwell time Highest risk of pneumothorax, the vessel cannot be compressed after arterial…

…acid Folate 7 nmol/L Electrolytes and renal function See the renal parameters for the eGFR stages and albuminuria. Inflammation and infection Test Reference Comment :…

…confused: replacement therapy in adrenal insufficiency (which must be increased under stress) and pharmacological anti inflammatory treatment (which must be tapered in a controlled fashion…

…anaphylaxis, deep neck infection, an expanding haematoma, facial trauma. An anticipated course requiring a secured airway — transfer, heavy sedation, surgery — and cardiac arrest. Contraindications There…

…Sampling for a suspected sexually transmitted infection — although chlamydia and gonorrhoea can be tested on urine or a self taken vaginal sample without a speculum…

…an antihistamine, oxygen, and the ability to lay the patient down. Injection Needle Angle Maximum volume per site : : : : Deltoid, adult 23–25 G, 25 mm…

…neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome, autoimmune encephalitis. Meningeal carcinomatosis and CNS involvement in haematological malignancy. Investigation…

…exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy…

…blood gas and electrolytes can be interpreted, but some laboratories do not accept marrow blood in their analysers — check locally. Contraindications Peripheral venous cannula: Infection…

…of the rib, never at the lower border where the neurovascular bundle lies, and the drainage is stopped for coughing, chest pain, or when the…

…parallel and must not wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection…

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…respiratory infection with a risk of transmission Until symptom free Haemoptysis of unclear cause Until investigated Relative obstacles also include dementia, marked hearing loss and…

…otherwise the treatment is ineffective. Hypocalcaemia , symptomatic. Alkalosis increases the binding of calcium to albumin and lowers ionised calcium further; risk of tetany and seizures…

…disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections. However, in some individuals the infection may be severe and deadly. Importantly…

…with several simultaneous renal insults. Infection, hypovolaemia, cardiac dysfunction, haemodynamic instability, anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast…

…A receptor. NT proBNP is an inactive cleavage product and has no direct biologic effect. BNP and NT proBNP have different clearance characteristics. Both undergo…

…inactive person becomes even modestly active, while additional activity continues to confer benefit with progressively smaller incremental effects. Some activity is preferable to none, and…

…blood flow or ineffective compressions. While ETCO 2 is optimally measured in tracheal tubes, it can also be gauged through supraglottic airway devices and Rubens'…

…food allergies, insect stings, and drug induced reactions. Approximately 90% of anaphylactic cardiac arrests present with pulseless electrical activity (PEA) as the initial rhythm, while…

…compressions are ineffective. This is explained by the elevated intrapericardial pressure due to the tamponade. The increased pressure causes compression of the atria and the…

…Nonetheless, prompt interventions can reverse cardiac arrest and survivors of traumatic cardiac arrest often exhibit favorable neurological outcomes ( Rawshani et al ). Traumatic cardiac arrests typically…

…a very large or deep abscess, a markedly unwell patient with fever and systemic upset, suspected necrotising soft tissue infection, a child who cannot tolerate…

…and does not delay treatment Saturation Give oxygen in hypoxia, not routinely to a normoxic patient Temperature Treat fever and look for an underlying infection…

…tract infection. At an eGFR <30 mL/min the antibacterial effect is lost. Dosed independently of renal function Doxycycline, erythromycin, clindamycin, metronidazole, moxifloxacin and fusidic…

…any retrieval: it begins when someone in the intensive care unit identifies a possible donor and the deceased person's own wishes are properly established…

…is ineffective. Known left atrial thrombus. A markedly enlarged left atrium, marked hyperthyroidism or an untreated underlying cause make recurrence all but certain and argue…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

Procedurer The single most important step in any eye injury is to measure and document the visual acuity before anything else is done. The second…

…ineffective and management is instead governed by the antidote, supportive treatment or dialysis: Group Examples : : Metals and salts Iron, lithium, potassium, lead, mercury Alcohols and…

…failure The insulin requirement falls . Reduce the dose and measure more frequently Acute illness and infection The insulin requirement rises, often despite a reduced food…

…compression The ankle brachial index measured with Doppler determines whether compression may be applied at all, and if so at what pressure. Palpable foot pulses…

…unit and which reference system your own laboratory uses before applying it. The D dimer is raised in pregnancy, malignancy, infection, surgery, trauma and old…

…with adrenaline 5 µg/mL (adrenaline gives a bloodless field and a longer duration; it is safe even on the fingers, toes, nose and ears)…

…can paradoxically worsen the bradycardia and must be avoided. Atropine acts on the sinus node and the AV node and is therefore ineffective — sometimes harmful…

…and acquired factors may interact in its development. PAH may be idiopathic, heritable, drug associated, or associated with conditions such as systemic sclerosis, HIV infection…

…infection or other circumstances that may affect cessation or treatment monitoring. Single question screening can identify unhealthy drug use requiring counselling regarding cardiovascular effects and…

…bezoars or is a sustained release formulation. Note: activated charcoal is ineffective against alcohols, lithium, and heavy metals. Enhance elimination Induce diuresis through urine alkalinization…

…particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an abrupt onset, although a brief warm up phase lasting…

…VF and finally asystole is the result of diminishing ATP concentration in the myocardium. ATP depletion results in cellular dysfunction and renders the defibrillation ineffective…